Table of Contents
Thrombosis
Volume 2012, Article ID 184573, 8 pages
http://dx.doi.org/10.1155/2012/184573
Review Article

Anticoagulant and Antiplatelet Therapy in Patients with Atrial Fibrillation and Coronary Artery Disease

1Department of Cardiology, Pneumology, Angiology and Intensive Care Medicine, University Hospital, RWTH Aachen University, 52072 Aachen, Germany
2Department of Cardiology, Maastricht University Hospital, 6202 AZ Maastricht, The Netherlands

Received 9 November 2011; Accepted 2 February 2012

Academic Editor: Louis M. Aledort

Copyright © 2012 Karl Mischke et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Anticoagulation represents the mainstay of therapy for most patients with atrial fibrillation. Patients on oral anticoagulation often require concomitant antiplatelet therapy, mostly because of coronary artery disease. After coronary stent implantation, dual antiplatelet therapy is necessary. However, the combination of oral anticoagulation and antiplatelet therapy increases the bleeding risk. Risk scores such as the CHA2DS2-Vasc score and the HAS-BLED score help to identify both bleeding and stroke risk in individual patients. The guidelines of the European Society of Cardiology provide a rather detailed recommendation for patients on oral anticoagulation after coronary stent implantation. However, robust evidence is lacking for some of the recommendations, and especially for new oral anticoagulants and new antiplatelets few or no data are available. This review addresses some of the critical points of the guidelines and discusses potential advantages of new anticoagulants in patients with atrial fibrillation after stent implantation.